7. PROJECT SUMMARY/ABSTRACT The United States is experiencing an opioid epidemic of historic significance, with over 40,000 deaths from overdose in the past year. The economic costs of the epidemic in 2015 alone were estimated at over $500 billion, and in 2017 the US Department of Health and Human Services designated the opioid epidemic as a public health emergency. National-level epidemiological data indicate that the rates opioid misuse, addiction, overdose, and fatalities are increasing at a particularly fast rate among women, and among individuals in child- bearing and child-rearing age groups. Opioid-using behaviors among women who are parenting can have significant detrimental effects on their parenting, parent-child relationships, and downstream effects on child brain development, health, and subsequent risk for drug use. The lack of a strong scientific knowledge base about effective strategies for reducing opioid abuse and addiction in this population is a gap of enormous consequences given the well-established effects of substance use on parenting skills, and the known effects of maternal opioid use on infant development. The limited research on this topic that does exist suggests that family-focused treatment approaches may hold the greatest promise, but the interventions that have been developed to date have limitations in terms of scalability. In addition to a need for scientific research on this topic, there is a parallel need to make reliable information available to researchers, policy makers, and the general public. The overall goal of the Prevention Research Center: Parenting Among Women Who Are Opioid Users (PWO Center) is to improve the well-being of individuals, families, and communities affected by the opioid crisis through a focus on behavioral (parental responsivity, warmth) and neurocognitive systems (e.g., executive functioning, reward responsiveness) that are underlying mechanisms common to both addiction issues and parenting challenges. The PWO Center's Research Projects and Cores are based upon a unifying conceptual model and employ a translational science approach in which basic science investigations of underlying mechanisms are leveraged in the development and evaluation of scalable interventions that are designed to deliver population-level impacts on policy and practice. Our multidisciplinary investigative team has been conducting research on family-based parenting interventions for families with substance use histories for the past 20 years and has a long and productive history of collaboration and productivity. We have strong support for the proposed PWO Center from our state governor, our community partners, and our university leadership. The anticipated long-term, public health outcomes of the PWO Center are to improve evidence- based prevention of substance abuse, reduce maternal opioid misuse and addiction, reduce intergenerational transmission of drug addiction, increase scientific understanding and public awareness of how opioids impact maternal parenting practices via underlying behavioral and neurocognitive mechanisms, ready the next generation of researchers and practitioners in this area, and increase evidence-based policy.